Breast Augmentation Implants 6 months post op Bottom Out and Lateral Displacement?

Thank you for the photos they confirm your suspicions. The high riding incision is an indication that the breast fold has been lowered. The correction for this can be done with suture techniques to close the space and restore the fold to its normal position.As far as the cleavage is concerned that is difficult to say from the photos. This is determined by the muscle attachment to the breast bone. A more projecting implant can help with the perception of cleavage even if the implants can not be placed closer together.Seek out a board certified plastic surgeon to evaluate you and give more detailed information on how to best proceed.Good luck and I hope this was helpful.

It does appear that you have bottoming out of the implants.  The lateral placement of the implants may be due to the diameter of the implants and your natural breast diameter and not necessarily lateral displacement.  You certainly can get more cleavage, but because you are thin and have naturally small breasts, you may have rippling in the medial aspect of your breasts if you try to get more cleavage or you choose to go with a significantly larger implant.  I don't necessarily recommend going with a higher profile implant, that may actually only make your gap larger or at best the same as it is now.  You would benefit from an in person exam so that your options can better be explained after a thorough breast exam. To decrease the gap in the cleavage you would need a larger base diameter implant.  To correct the bottoming out, you would need a capsulorraphy, internal suturing of the lower aspect of your breasts, and perhaps the outer aspect, depending on the final size of implant that you would be choosing.  Good luck!  

You have a very common issue that the fix has a high rate of success. My recommendation would be to perform a lateral and inferior capsulorrhaphy (suturing the pocket on the sides and bottom) and an implant exchange to larger smooth round silicone implant. Find a board certified plastic surgeon in your area that has extensive experience in these types of surgeries. Best of luck to you.

Thank you for your question and reviewing your concerns.  Smooth silicone implants can work very well for most patients.  There is a subset of patients, however, in which the implants settle excessively and fall laterally (to the side).  This is more likely to happen if you had limited supportive breast tissue or stretchable skin.  It is also more likely to occur if your ribcage angles outwards, because the implants will always want to follow the angulation of the chest.  When you lay down, the implants will want to stretch the side of your breasts and stretch-out the pocket.Sometimes, a capsulorrhapy is all that is needed to improve your situation.  In this procecure, the doctor will tighten and reduce the size of your pockets such that the implants move up and in.  The capsulorrhapy can be strengthened with a supportive material such as Seri (silk mesh) or ADM.    Textured implants can be helpful, but require a moderate amount of breast tissue to conceal (to avoid wrinkling).  I would recommend speaking to your doctor about your concerns and you should get some good options.  Best wishes!

You have malposition with bottoming out that will require capsular sling and tightening of the inframammary fold. Seek a breast revision specialist in your area. 

Every woman has different space dimentions in their cleavage area, and in your particular case, it seems that you were born with a wide cleavage.  Your augmentation looks very good, and if you were going to have a revision, your surgeon could use somewhat larger implants to decrease the space between your breasts.

Your photos demonstrate inferior and lateral displacement of your implants. This can be corrected by closing-down the pocket to shift the implants to a more medial and superior location. Because the nipple/areola move opposite that of the implants, this will bring their position down. Also, the incision scars should move downward toward the fold, where they will be less visible. This correction can be performed with or without the addition of any number of reinforcing materials to add strength to the repair. The implants themselves do not appear to be too large at all for your frame size, based on your photos. I hope that this is helpful. Best of luck with your corrective surgery.

I am sorry to hear about your concerns after breast augmentation surgery. Based on your description and photographs (which demonstrate your concerns nicely), it is likely that you are dealing with a breast implant displacement issue;  the breast implants are moving too inferiorly when you stand and off to the sides when you lie down. The procedure that will likely improve your situation is called capsulorrhaphy;  this procedure involves the use of sutures internally along the breast implant capsule, surrounding the breast implants. It involves decreasing the space surrounding the breast implants, by removing some of the capsule tissue and re-suturing the excised edges.  In my practice, this repair is done with a 2 layered suture technique. The use of acellular dermal matrix is an option,  depending on patient physical examination and history, especially if significant implant rippling/palpability is present.

In other words, the "volume" of the  capsule (scar) tissue space surrounding the breast implant is decreased in size. This procedure is commonly performed to treat breast implant displacement or malposition concerns such as lateral displacement (breast implants “falling” off to the sides), bottoming out of breast implants, and/or symmastia. The procedure may also be helpful when patients are downsizing breast implants.   I hope this, and the attached link (dedicated to revisionary breast surgery concerns, helps. Best wishes.

275cc is not considered an excessively large implant and would not be the sole cause of implant malposition. It is possible to reposition your implants by internal suture (capsulorrhaphy) and some times supported by an internally placed material (ADM - acellular dermal matrix or Seri Silk Scaffold). I recommend you speak with your board-certified plastic surgeon about your concerns. I wish you well.Dr. Edwards

Thank you for the photos and questions and sorry for your problem.  The good news is that it can be fixed so see some experts in your area Dr Corbin